Opinion: jazz, techno, electronic, pop, soul or even Michael Bublé - music in the right setting can reduce a patient's experience of pain

By Claire Howlin, UCD

Even without the presence of a music therapist, listening to music has been shown to reduce people’s experience of pain. This is not necessarily a quick fix like you might expect with a pharmacological treatment, but music can help you to tolerate pain for longer or experience pain of a greater intensity before you feel it as painful or uncomfortable. This effect is also seen in the neural and biological responses we have to music.

Music has been shown to directly activate the pleasure and reward circuits of the brain, known as the striatum, and may help to release endogenous opioids in the pain networks of the brain. This is supported by how patients in some music listening studies have been shown to need less opioid based medication than they normally would, which suggests that music effects the same brain networks that the opioid medication does. We know that many opioids already exist in your brain naturally, and music may help to release these to reduce the activity in the pain network.

But as with most areas of science, there are certain instances where this effect is more obvious than others. When we look at research that is carried out under lab conditions, where the pain is created for the purpose of the experiments using an electric shock or a heat source and there are no other competing distractions, we see that this effect is very strong.

However, when we try to implement this finding into a hospital setting, we see that the effect is harder to reproduce. This may be because naturally occurring pain can have complex emotional components or because the hospital environment itself might actually be distressing or noisy and add to the experience of pain. The noise and distraction of a hospital might make it difficult to actually hear the music, which might explain why we get different results than we see in the lab.

The important thing is to create an environment that allows you to focus on and enjoy the actual music for 20 to 30 minutes up to four times per week

Another twist in the tail comes from when you compare music heard in sound excluder headphones. The latter can help people to feel less pain in a hospital setting, indicating that the actual environment we are in can really contribute to how much pain we experience. Anyone who has been in hospital surrounded by beeps, whirrs and chatter will appreciate how these competing sounds could prevent you from focusing on music. While music may effect us biologically, it can only do this if we are able to concentrate mentally interact with the music.

Now that we know this, people who experience chronic pain such as arthritis, fibromyalgia, or neuralgia can be advised to listen to music as a complementary method of pain control. Usually, this is done in an otherwise quiet and peaceful environment, on a full stomach without any competing distractions. Of course, this can be done in a hospital, but it can also be done at home or in any relatively quiet place with few distractions.

The important thing is to create an environment that allows you to focus on and enjoy the actual music for 20 to 30 minutes up to four times per week. Currently, our lab is focusing on ways to examine the interaction between individuals and the environment using virtual reality. This will help us to see if it the environment really can disrupt the beneficial effects of music listening on pain experience, or whether it could be something else, like the emotional impact of naturally occurring pain.

What's on your pain playlist?

Another important aspect to consider is the actual music itself. Many research studies use music with a slow tempo and gentle rhythms, with the hope that this gentle style of music would help to slow down your heart rate and breathing rate, which would indirectly help to reduce your experience of pain due to decreased physiological arousal.

However, it is now clear from several meta-analysis that the music chosen by the patient is more effective than any music chosen by the researchers. It doesn’t matter if the music is jazz, techno, electronic, pop or soul: the main thing is that the patient is familiar with it and likes it. It’s not quite clear why this might be, but it may be related to the fact that you are more likely to have a pleasurable experience towards music that you know, perhaps due to a positive association or specific memory with the music, which can lead to greater activation in the reward centres of the brain.

Some patients also report choosing music with particularly uplifting lyrics to help them to keep motivated to continue with their daily routine, despite the fact that they’re in pain. However, there are also suggestions that music with a slow tempo which is highly positive can also be even more beneficial, such as soul music or Michael Bublé - as long as you know and like the music in question.

Claire Howlin is a doctoral researcher in the cognitive mechanisms in music listening at the Media and Entertainment Lab at the School of Psychology at UCD. She was awarded an Irish Research Council Postgraduate Scholarship in 2017 and is currently chair of the Psychological Society of Ireland special interest group for psychology of media, arts and cyberpsychology.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ